6 results for Denials Specialist in Torrance, CA

Credentialing Specialist

West Hollywood, CA
onsite
Temporary
25 - 45 USD / Hourly
The Credentialing Specialist is responsible for supporting the credentialing, re‑credentialing, and provider enrollment processes to ensure healthcare professionals meet all regulatory, payer, and organizational requirements. This role plays a key part in maintaining compliance, supporting provider onboarding, and ensuring accurate and up‑to‑date credentialing records. The Credentialing Specialist works closely with internal teams, providers, and external agencies to collect, verify, and track required documentation.<ul><li>Coordinate and manage initial credentialing and re‑credentialing for healthcare providers</li><li>Collect, review, and maintain provider documentation (licenses, certifications, education, work history, malpractice coverage, etc.)</li><li>Perform primary source verification in accordance with regulatory and organizational standards</li><li>Track license, certification, and enrollment expiration dates to ensure ongoing compliance</li><li>Maintain accurate provider records within credentialing databases and internal systems</li><li>Communicate with providers and internal stakeholders regarding application status and missing documentation</li><li>Assist with payer enrollment and revalidation processes, as assigned</li><li>Support audits and ensure credentialing files are complete and compliant</li><li>Maintain confidentiality and comply with HIPAA and regulatory requirements</li><li>Perform additional administrative or credentialing support duties as needed</li></ul>Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
2026-03-21T00:00:00Z

Leave of Absence Specialist

Van Nuys, CA
onsite
Temporary
27 - 35 USD / Hourly
The Leave of Absence (LOA) Specialist is responsible for administering and managing all aspects of employee leave programs. This role ensures a smooth, compliant, and employee-centered leave process while partnering closely with HR, managers, and external vendors. Key Responsibilities:<ul><li>Administer end-to-end leave of absence processes, including FMLA, state leaves, disability, and company-sponsored leave programs</li><li>Serve as the primary point of contact for employees and managers regarding leave policies, eligibility, and procedures</li><li>Review, track, and maintain accurate leave documentation and records in compliance with applicable laws and internal policies</li><li>Coordinate with third-party administrators, payroll, and benefits teams to ensure accurate leave processing and pay continuity</li><li>Monitor leave timelines, extensions, and return-to-work processes, including accommodations when applicable</li><li>Ensure compliance with federal, state, and local regulations, including FMLA, ADA, and other applicable leave laws</li><li>Provide guidance to managers on employee leave situations and best practices</li><li>Identify opportunities for process improvement and contribute to HR projects and initiatives</li><li>Maintain confidentiality while handling sensitive employee information</li></ul>
2026-04-03T00:00:00Z

Medical Billing Specialist

Van Nuys, CA
onsite
Temporary
25 - 35 USD / Hourly
We are seeking an experienced Medical Billing Specialist to manage end‑to‑end billing functions for a multi‑specialty healthcare practice. This role is responsible for claim submission, payer follow‑up, collections, and quality control across multiple providers, with exposure to concierge and out‑of‑network billing models. The ideal candidate is detail‑oriented, payer‑savvy, and comfortable managing both payer and patient communications while driving A/R resolution. Key Responsibilities:<ul><li>Manage end‑to‑end medical billing, including claim submission, follow‑ups, payment resolution, and collections</li><li>Review charges and support coding accuracy for approximately 3–4 multi‑specialty providers prior to claim submission</li><li>Perform quality control and audit reviews of billing work completed by the billing team</li><li>Handle courtesy out‑of‑network (OON) billing and support concierge‑model practices</li><li>Manage high‑volume phone and email correspondence with insurance payors and patients</li><li>Follow up on unpaid, denied, or underpaid claims to reduce A/R backlog</li><li>Support sales collections and reimbursement initiatives</li><li>Maintain accurate billing documentation and detailed account notes</li><li>Ensure compliance with payer requirements, internal workflows, and industry best practices</li></ul>Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
2026-03-31T00:00:00Z

Medical Billing Specialist

La Puente, CA
onsite
Contract / Temporary to Hire
23.75 - 28.23 USD / Hourly
A Larger Medical Center in the La Puente Area is in the need of a d Medical Billing Specialist with strong Medi-Cal insurance experience. The Medical Billing Specialist will play a key part in managing the revenue cycle and ensuring accurate billing for Medi-Cal programs. The Medical Billing Specialist must have expertise to maintain compliance with provider guidelines and optimize reimbursement processes. Experience in OBGYN and/or Perinatal Services is a bit plus. Responsibilities:• Verify patient eligibility for Medi-Cal and confirm Managed Care Plan assignments for services rendered.• Prepare and submit claims accurately using appropriate coding and modifiers, including electronic equivalents of CMS-1500 forms.• Post payments, reconcile accounts, and ensure adjustments and write-offs align with contractual requirements.• Analyze denied or underpaid claims, identify issues, and resubmit them to secure proper reimbursement.• Manage appeals by reviewing Explanation of Benefits and engaging with the appeals process to resolve claim discrepancies.• Maintain secure and compliant records of Protected Health Information used in billing activities.• Assist healthcare providers with billing inquiries and support case management practices to enhance revenue.• Ensure all billing activities align with Medi-Cal Provider Manual and Managed Care Plan guidelines.• Collaborate with internal teams to streamline billing processes and improve efficiency.
2026-04-03T00:00:00Z

Medical Billing Specialist

Van Nuys, CA
onsite
Contract / Temporary to Hire
25.3365 - 29.337 USD / Hourly
We are looking for a skilled Medical Billing Specialist to join our team in Los Angeles, California. This Contract to permanent position offers an exciting opportunity to manage comprehensive billing operations for a multi-specialty healthcare practice, with a focus on Ear, Nose, and Throat services. The ideal candidate will have expertise in claim submission, collections, and patient communications, as well as experience with out-of-network and concierge billing models. Responsibilities: • Manage the full cycle of medical billing processes, including claim submissions, payer follow-ups, payment resolutions, and collections. • Review and ensure the accuracy of coding and charges for services provided by multi-specialty healthcare providers. • Conduct quality assurance checks and audits of billing tasks performed by team members. • Handle out-of-network billing and provide support for concierge-model practices. • Investigate and resolve unpaid, denied, or underpaid claims to minimize accounts receivable backlog. • Assist with collections and reimbursement strategies to optimize revenue. • Maintain detailed and accurate billing records, including comprehensive account documentation. • Ensure compliance with payer policies, industry standards, and internal workflows. • Utilize systems such as Kareo/Tebra and eClinicalWorks effectively to streamline billing operations.
2026-04-01T00:00:00Z

Routing Specialist

South Gate, CA
onsite
Contract / Temporary to Hire
20 - 24 USD / Hourly
We are looking for a highly organized Routing Specialist to join our logistics team in South Gate, California. This Contract to permanent opportunity offers a chance to play a key role in managing and optimizing transportation schedules for a leading logistics company. The ideal candidate will excel in coordinating routes, leveraging advanced Excel skills, and ensuring seamless communication across teams. Responsibilities: • Develop and implement efficient routing plans to streamline delivery schedules and enhance operational performance. • Utilize advanced Excel functions, such as pivot tables and VLOOKUPs, for data analysis, shipment tracking, and reporting. • Coordinate with drivers, dispatchers, and warehouse staff to ensure timely and accurate deliveries. • Monitor shipments in real-time and resolve any delays or issues proactively to maintain service quality. • Maintain comprehensive records of routes, schedules, and transportation costs for accurate reporting and analysis. • Communicate effectively with internal teams and external partners to ensure alignment on logistics operations. • Ensure all transportation activities comply with company policies and industry regulations. • Provide support in managing business systems, including ERP and CRM tools, to enhance operational efficiency. • Collaborate with the billing team to ensure accurate invoicing and documentation of services.
2026-04-03T00:00:00Z